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Medicare has officially expanded coverage for patients at risk for heart disease to include Wegovy.
Part D plan enrollees now have access to the popular weight-loss drug when specifically prescribed as a treatment to prevent strokes and heart attacks, according to the Centers for Medicare and Medicaid Services (CMS).
According to NPR, Wegovy is classified as a GLP-1 agonist, meaning it relies on hormones and the brain to suppress appetite.
Medicare, which provides insurance to more than 65 million people in the United States, was previously prohibited from covering any form of weight loss drugs, according to CMS data. However, a recent ruling by the Food and Drug Administration expanded approval to allow Wegoby to be prescribed only if the patient is overweight to reduce the risk of heart disease.
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Their decision came after a 2023 clinical trial showed the drug reduced the risk of heart disease by 20 percent in overweight people. washington post.
The same decision to allow Wegovy coverage also applies to state Medicaid plans. However, as of this writing, Medicare does not cover the drug if it is used solely for weight management.
CMS told NPR in a statement that it is “committed to ensuring people have access to treatments and treatment options that improve health outcomes.”
Wegovy, like the related semaglutide drug Ozempic, has become popular among celebrities for weight loss purposes. Oprah Winfrey, KiKi Palmer, Amy Schumer and others have alluded to its recent prevalence both in and out of Hollywood.
“The most common side effects of these drugs are nausea and diarrhea, and in some cases vomiting and constipation,” Ania Jastrebov, MD, told PEOPLE in January.
“If you increase the dose of the drug too quickly, you’re more likely to experience these side effects,” Jatlebov said.
Acceptance of new drug coverage by Medicare typically occurs before private insurance companies begin paying. It remains to be seen whether other companies will follow Medicare’s lead and offer coverage options to Wegovy.
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